Patients let down, says NHS boss in apology

One report found patients were kept like "animals" at the now closed Tawel Fan ward at Ysbyty Glan Clwyd, Bodelwyddan, Denbighshire

A fresh apology has been issued over the "poor care" received by some patients at Wales' biggest health organisation.

It follows a review into the action taken in the wake of four critical reports into mental health services run at Betsi Cadwaladr University Health Board dating back to 2013.

The organisation manages the NHS in north Wales.

An update is due to be presented to its board on Thursday looking at how recommendations from previous reports have been implemented.

Chief Executive Carol Shillabeer, who was not in post when the four reports were published, said the review "provides an opportunity for the board to offer a further public apology to that of previous boards regarding the poor care that was provided in the past".

"It is clear that the NHS in north Wales, and specifically the health board, let down patients and their families at a time when they were at their most vulnerable," she wrote in the update.

What were the four reports about?

• The Holden Report (2013) said a breakdown in staff and manager relations at Hergest Unit, Ysbyty Gwynedd, put patients at risk

• First Ockenden Report (2014) found patients were kept like "animals" at the now closed Tawel Fan ward at Ysbyty Glan Clwyd

• The Health and Social Care Advisory Service Report (2018) looked at the cases of 108 former Tawel Fan patients

• Second Ockenden Report (2018) described mental health care in north Wales as a "Cinderella service" with senior management heavily criticised

Last year, the Welsh government commissioned the review of progress which was carried out by the Royal College of Psychiatrists' Invited Review Service (IRS), supported by the Royal College of Nursing Wales.

The review team used a traffic light system to assess the implementation of recommendations of all four reports, focusing on patient and user-centred care, legislation and clinical guidelines, staffing, management structure, clinical services organisations, training, resources and physical environment.

The review raises concerns over a large number of interim posts, with some staff in such roles for "a significant period of time"

What did the latest review find?

• Of the 84 recommendations, six were given a red rating, meaning there was no evidence of implementation

• 41 were rated as amber, indicating that some, but not good, progress had been made

• 31 were rated as green, with good or strong evidence of the recommendations being put into practice

• Among the concerns highlighted wre the lack of electronic records and the lack of investment in infrastructure, although bosses have said that is being addressed

"We think that the lack of an electronic record system in a board that has many units scattered over a very large geographical area with multiple clinical teams leads to a significant governance risk in terms of information sharing and access to up-to-date and contemporaneous clinical records," said the review.

The team also raised concerns by the large number of interim posts, with some staff having been in such roles for "a significant period of time".

The health board employs more than 19,000 staff and provides NHS care across north Wales, with a budget in excess of £1.8bn

In response, Chief Executive Ms Shillabeer said progress was being made on the implementation of electronic records, with talks held with Welsh government officials.

"The events that have been subject to fundamental and important review must continue to be a matter of significant regret and essentially the reason to drive forward improvements," she said, in the report.

"There is a need to reaffirm the health board commitment to providing the best possible health and care service to people who have dementia specifically, as well as people in need of wider mental health services."